Applying an Extended UTAUT2 Model to Explain User Acceptance of Lifestyle and Therapy Mobile Health Apps: Survey Study (Preprint)

Abstract

Mobile health (mHealth) care apps are a promising technology to monitor and control health individually and cost-effectively with a technology that is widely used, affordable, and ubiquitous in many people’s lives. Download statistics show that <i>lifestyle apps</i> are widely used by young and healthy users to improve fitness, nutrition, and more. While this is an important aspect for the prevention of future chronic diseases, the burdened health care systems worldwide may directly profit from the use of <i>therapy apps</i> by those patients already in need of medical treatment and monitoring.

We aimed to compare the factors influencing the acceptance of lifestyle and therapy apps to better understand what drives and hinders the use of mHealth apps.

We applied the established unified theory of acceptance and use of technology 2 (UTAUT2) technology acceptance model to evaluate mHealth apps via an online questionnaire with 707 German participants. Moreover, trust and privacy concerns were added to the model and, in a between-subject study design, the influence of these predictors on behavioral intention to use apps was compared between lifestyle and therapy apps.

The results show that the model only weakly predicted the intention to use mHealth apps (<i>R</i>²=0.019). Only hedonic motivation was a significant predictor of behavioral intentions regarding both app types, as determined by path coefficients of the model (lifestyle: 0.196, <i>P</i>=.004; therapy: 0.344, <i>P</i>&lt;.001). Habit influenced the behavioral intention to use lifestyle apps (0.272, <i>P</i>&lt;.001), while social influence (0.185, <i>P</i>&lt;.001) and trust (0.273, <i>P</i>&lt;.001) predicted the intention to use therapy apps. A further exploratory correlation analysis of the relationship between user factors on behavioral intention was calculated. Health app familiarity showed the strongest correlation to the intention to use (<i>r</i>=0.469, <i>P</i>&lt;.001), stressing the importance of experience. Also, age (<i>r</i>=–0.15, <i>P</i>=.004), gender (<i>r</i>=–0.075, <i>P</i>=.048), education level (<i>r</i>=0.088, <i>P</i>=.02), app familiarity (<i>r</i>=0.142, <i>P</i>=.007), digital health literacy (<i>r</i>=0.215, <i>P</i>&lt;.001), privacy disposition (<i>r</i>=–0.194, <i>P</i>&gt;.001), and the propensity to trust apps (<i>r</i>=0.191, <i>P</i>&gt;.001) correlated weakly with behavioral intention to use mHealth apps.

The results indicate that, rather than by utilitarian factors like usefulness, mHealth app acceptance is influenced by emotional factors like hedonic motivation and partly by habit, social influence, and trust. Overall, the findings give evidence that for the health care context, new and extended acceptance models need to be developed with an integration of user diversity, especially individuals’ prior experience with apps and mHealth.